*Received for publication July 23, 1958.From the Department of Medicine, The New York Hospital-Cornell Medical Center, New York, N. Y.†Present address: Captain, 7520th USAF Hospital, South Ruislip, England.Requests for reprints should be addressed to Marvin H. Sleisenger, M.D., Associate Professor, Department of Medicine, The New York Hospital-Cornell Medical Center, 525 East Sixty-eighth Street, New York 21, N. Y.

Abstract

Although abdominal pain is common in the preicteric phase of acute viral hepatitis, it is rarely of sufficient intensity to simulate an acute surgical condition; occasionally, however, there is not only severe distress but also marked upper abdominal tenderness, direct and rebound. Because of the dangers in laparotomy in individuals with liver disease, awareness that hepatitis may simulate an abdominal disorder which requires surgery is important. Correct early diagnosis is imperative, and may be facilitated by measurement of serum glutamic oxaloacetic transaminase and the clinical effect of corticotropin (ACTH). Our recent experience with such a patient is reported.